STARVATION 183 has been lowered from fatigue, want of food, indulgence in alcoholic drinks and previous ill-health, are less able to withstand the effects of cold than healthy, well-nourished adults of temperate habits. Owing to a greater deposit of subcutaneous fat—a non-conducting material—women are likely to ensure cold longer and better than men. Dry cold is less harmful in its effects than moist cold air. Symptoms—Local.—These appear on the skin in the form of £iythe- matous patches, called frost-bites (frost-erythems) and chilblains produced by constriction of the cutaneous vessels which deprives the tissues of their nourishment. The exposed parts, such as the ears, nose, fingers and toes, are usually affected. The condition of frost-bite being a vital action can never be produced after death. General.—These are no bad effects from moderate cold. On the contrary, it invigorates the body, and produces appetite and hunger ; but exposure to severe cold continued for a long time produces deleterious effects, especially if a person is not properly clothed to keep up the body heat, and does not get sufficient food or exercise. The skin becomes pale and numb; sometimes it assumes a dusky, reddish and livid hue with the formation of vesicles. The muscles become so stiff, rigid and heavy, that the patient is unable to move or raise his limbs. This condition is followed by general lethargy, drowsiness and inclination to sleep which, if not controlled, passes gradually into stupor, coma and ultimately death. Some- times convulsions, hallucinations and delirium occur before death. Cause of Death.—Death occurs from a lesser supply of oxygen to the nervous centres and tissues, as haemoglobin is unable to part with it at a lower temperature. Treatment.—This consists in covering the patient with woollen garments and placing him immediately in a warm bed. Hot water bottles should be applied to the surface, and the warmth of the body should be gradually restored by rubbing the limbs with flannel or hot towels. Hot coffee or tea and other stimulants, such as strychnine, digitalis, and alcohol, should be administered. Enemata of warm normal saline are very beneficial. It may be necessary to treat nephritis and other inflammatory conditions, if they arise after the reaction has set in. Post-mortem Appearances—External.—The surface of the body is usually pale, marked with irregular, dusky red patches of frost-erythems, especially on the exposed parts, such as the tips of the fingers and toes, nose, lips and ears. These do not appear on the dependent parts as in post- mortem staining. Rigor mortis is slow to appear and hence lasts longer. If a body buried in snow is found in a condition of commencing decom- position, death is very likely not from cold, which prevents decomposition. Internal.—The brain is congested with effusion of serum into its ventricles. The heart contains fluid blood in both the chambers. The lungs and other organs are congested. Owing to the combination of oxygen with haemoglobin, the blood is bright red in colour except in the heart, where it appears dark when viewed en masse. Medico-Legal Aspect—Death from cold is mostly accidental, thougfct very rare in India. Drunkards may be found dead in streets, when exposed to cold on a wintry night. Death from cold may form a case for medico- legal enquiry, as a newly born infant is sometimes murdered by exposure to cold by depriving it of the necessary clothes. Questions of-responsibility as to homicide may arise in cases where insane, aged, sick or wosmcled persons have died from exposure to cold. A newly-born male infant* two or three days old, was found dead iron* at night in the compound of a bungalow at Agra.